Repost of an article by Steven Johnson, an independent writer, speaker and creative consultant specialising in sustainability, CSR and behaviour change. He blogs and tweets as @Considered. Original article at The Guardian.

Experts in public health have struggled with enabling behaviour change for years. The sustainability sector should learn what it can from their experiences:

Consumer behaviour change is the challenge of our time. As governments and brands are beginning to realise, upstream improvements are relatively easy to make compared with the herculean task of shifting consumer behaviours downstream.

While the sustainability community is just beginning to get to grips with the gravity of this challenge, our colleagues in public health have been wrestling with it for decades. Great progress has been made, but hard lessons have been learned – costly, time-consuming lessons that we can all learn from.

“One of the penalties of an ecological education is that one lives alone in a world of wounds. Much of the damage inflicted on land is quite invisible to laymen. An ecologist must either harden his shell and make believe that the consequences of science are none of his business, or he must be the doctor who sees the marks of death in a community that believes itself well and does not want to be told otherwise.”

Adolescents warrant special attention. From a road safety perspective, they carry the largest crash and morbidity/mortality risk of any age group. This has led to considerable research and safety programs, but these efforts have plateaued in many countries and remain fixed within a road safety perspective. From a broader perspective, little has been done about the many non-traffic health risks related to teen driving (increased drug and alcohol use, anti-social behaviour, sexually transmitted infections, inactivity and obesity). From a sustainable transport perspective, a contemporary imperative, teens are where the transition from non-driver to driver takes place; an opportune time for interventions to minimize environmental harms.Professor Weiss introduces a new paradigm termed ‘mobility health’ to bridge the siloed domains of safety, adolescent health and sustainable mobility. In this passionate speech to an international audience, he advocates changing the current narrow paradigm of adolescent road safety to a cross-level/cross-disciplinary, more potent, timely and healthy vision of less driving through mobility modal shift from cars to active and public transport.

It is, perhaps, the greatest failure of collective leadership since the first world war. The Earth’s living systems are collapsing, and the leaders of some of the most powerful nations – the US, the UK, Germany, Russia – could not even be bothered to turn up and discuss it. Those who did attend the Earth summit last week solemnly agreed to keep stoking the destructive fires: sixteen times in their text they pledged to pursue “sustained growth”, the primary cause of the biosphere’s losses.

This is the way the world ends This is the way the world ends This is the way the world ends Not with a bang but a whimper.

–T.S. Eliot, “The Hollow Men”

The modern end-of-the-world imagination often seeks out great Hollywood-style cataclysms: an asteroid collision, all-out nuclear war, a solar flare that wipes out the electrical grid, even a worldwide epidemic that leaves few alive. Less compelling is the possibility of relentlessly rising death rates that finally overwhelm birth rates and quietly set worldwide population on a downward path.

While such a development would (gruesomely) address population pressures over time, it would be both highly disruptive–the costs of coping would be very high compared to family planning–and also morally repugnant if allowed to occur through intentional neglect.

The idea that a decline could unfold in this manner, however, is so far from any policymaker’s mind that it doesn’t even seem to register. And, yet the seeds for it are being sown right now. As the world economy continues to sputter, government revenues fall. More and more nations are embracing fiscal austerity and public health budgets are being cut. The situation has become exceedingly dire for Greek citizens whose health care system is being slashed to meet austerity targets demanded by Eurozone lenders as the price for keeping the government financially afloat. Because many pharmacies have not received government payments for drugs they dispense in such a long time, these pharmacies are now demanding cash up front. And, impoverished Greeks are finding it difficult and often impossible to pay.

Abstract: “We make a case in this article for re-orienting public health, based on evidence that societies across the globe are now facing inevitable change for which public health remains insufficiently prepared. We focus on the relationship between different sustainability ideals, displayed through rhetoric and discourse and the reality of a number of challenges in the ‘modern’ world. We briefly describe discernible elements of public and policy rhetoric around sustainability, as an important background for public health efforts, and present two significant public health discourses. We then outline some of the challenges to sustainability; some relate to the powerful social systems and cultural values associated with modernity, while others refer to broader environmental issues. These are not unconnected. We conclude by outlining the possibilities for ustainability, which include a transition to a more sustainable form of society that could lessen global inequalities, combat emerging problems, such as obesity, depression and addictive behaviours, and improve individual and social levels of well-being. We believe that this may well require a change of consciousness for a change of age, so the scope and scale of the required response should not be underestimated.”

“Public health must continually respond to new threats reflecting wider societal changes. Ecological public health recognizes the links between human health and global sustainability. We argue that these links are typified by the harms caused by dependence on private cars.”

Editors Note: This reprint is from Sharon Astyk’s blog (Casaubon’s Book). She’s not the first to make the connection between the now almost global car culture and huge public health and environmental costs, but in her indomitable style she says it succinctly and she says it well. A more academic piece with the same thoughts quantified was published a few months ago in the Lancet. [Woodcock J, Edwards P, Tonne C, Armstrong BG, et al. “Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport”, The Lancet, Volume 374, Issue 9707, Pages 1930-2114]

One of the pleasures of blogging here has been the focus that this community has on issues of public health. Doing everything we can to maintain the health and well-being of populations through a shift into a different model of life is an issue that is deeply important to me – I don’t always agree with everyone who writes here on these issues (and, of course, they don’t always agree with each other ;-)), but I am struck with admiration of the degree of concern for the public welfare expressed by my Science Blog Colleagues.

Which is why I’m being so presumptuous (since I am a science writer, not a physician or medical researcher) as to suggest a new direction for my fellow bloggers who focus on public health issues. With any luck they will find that now that Andrew Wakefield’s false claims about vaccine-autism link are thoroughly discredited (for the bazillionth time – and can I just say how pleased I am, since I personally, as the parent of a child with severe autism, would like to know what actually *does* cause autism and we’re unlikely to find that out it by doing another 40 studies on a discredited line of reasoning) that they have some free time on their hands. My suggestion would be to focus on another public health crisis – arguably the biggest one we face – our dependence on cars for personal transportation.

Editors Note: This reprint is from Michael Tobis’ excellent Climate Change blog, “Only in it for the Gold.” It deals with the rampant and almost epic problem of the failure of science communication to prevent corruption of climate science. Eventually (many would argue it already has), the same techniques may very well be directed towards energy decline and its likely impact on modern health care and public health. It is one of the tenants of this site that many health professionals have not only the skills but the duty to lead efforts to redress this problem.